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Tumor characteristics, treatments, and oncological outcomes of prostate cancer in men aged ≤50 years: a population-based study

Prostate Cancer and Prostatic Diseasesvolume 21pages7177 (2018) | Download Citation



To examine clinical characteristics, treatment modalities and oncological outcomes of prostate cancer (PCa) according to young (≤50) vs. old age.


Of 407,599 men with primary adenocarcinoma of the prostate within the Surveillance, Epidemiology and End Results (SEER)-database (2004 to 2013), 18,387 were aged ≤50 years (4.5%). Time trends, cumulative incidence, and competing risks regression (CRR) analyses tested for differences between young and old patients. Multi-variable analyses were adjusted for year of diagnosis, race, marital status, Gleason Score, clinical tumor stage, and lymph node status.


Younger men had more favorable tumor characteristics: lower Gleason Score, lower median PSA, and lower rates of metastases at diagnosis compared to their older counterparts. Over time, no local treatment (NLT) rates increased, radical prostatectomy (RP), and brachytherapy (BT) rates decreased and external beam radiation (EBRT) rates remained unchanged. Moreover, the rate of de novo metastatic prostate cancer increased in young patients from 2% (2004) to 3.2% (2013) (p= 0.004). CRR models showed no difference in prostate cancer-specific mortality (PCSM) between young and old, across all local treatment types.


Young PCa patients have more favorable disease characteristics at presentation, are less frequently treated with RP or BT and more frequently benefit of NLT. PCSM did not differ between young and old patients. However, it is worrisome that recently more young PCa patients are diagnosed at a metastatic stage.

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  1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    • Raisa S. Pompe
    • , Felix Preisser
    • , Sami-Ramzi Leyh-Bannurah
    • , Hartwig Huland
    •  & Markus Graefen
  2. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada

    • Raisa S. Pompe
    • , Ariane Smith
    • , Marco Bandini
    • , Michele Marchioni
    • , Tristan Martel
    • , Sami-Ramzi Leyh-Bannurah
    • , Fred Saad
    • , Derya Tilki
    •  & Pierre I. Karakiewicz
  3. Department of Urology, University of Montreal Health Center, Montreal, QC, Canada

    • Ariane Smith
    • , Tristan Martel
    • , Fred Saad
    •  & Pierre I. Karakiewicz
  4. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    • Marco Bandini
  5. Department of Urology, SS Annunziata Hospital, “G.D’Annunzio” University of Chieti, Chieti, Italy

    • Michele Marchioni
  6. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    • Sami-Ramzi Leyh-Bannurah
    •  & Derya Tilki
  7. Department of Urology, Academic Hospital Braunschweig, Braunschweig, Germany

    • Jonas Schiffmann
  8. Department of Urology, University of Vienna, Vienna, Austria

    • Shahrokh F. Shariat


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Conflict of interests

The authors declare that they have no competing interests.

Corresponding author

Correspondence to Raisa S. Pompe.

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